Background: Most of the chronic iliofemoral venous obstructions were managed with low morbidity and no mortality through endovascular intervention which was appropriate for patients with chronic venous obstruction. Endovascular treatment for iliofemoral venous obstruction had progressed rapidly,venous stenting was the primary choice as the stent placement was safe, effective and minimally invasive. However, surgical treatment remains an excellent option in cases in which endovascular techniques had failed or weren't possible.
Objective: The purpose of this study was to review and discuss comparative study between surgical and endovascular procedures in the management of chronic iliofemoral venous obstruction.
Patients and Methods: This study included 30 patients (18 females and 12 males) with a ratio of 1.5:1 suffering from chronic ilio-femoral venous obstruction, randomly divided into two equal groups: group (1) for surgical treatment,group (2) for endovascular treatment. Their mean age was 40 years “ranging from 19-83 years" . All patients were belonging to CEAP classifications, C(clinical), E(etiological), A(anatomical) and P(pathological) which included C3 to C6 = clinically state of venous disease in which there was edema up to active venous ulcer.
Results: There was no difference between the groups regarding the length of follow up. Iliofemoral venous stenting was safe and effective procedure which could be performed with low morbidity, no mortality, and long-term high patency rate  patients for open venous surgery had complication with low patency rate.
Conclusion: Endovascular treatmentis the primary treatment for patients with chronic iliofemoral venous obstruction, open surgical treatment should be considered only in cases of unsuccessful or failed endovenous treatment.